Newer Drugs for Visceral Leishmaniasis: a Review

Visceral Leishmaniasis (VL) is one of the most neglected tropical diseases worldwide. The diagnosis and treatment of this disease is quite complex. Sodium Antimony Gluconate (SAG) which used to be a very effective treatment has now developed resistance and is potentially a cardio-toxic drug. Pentamidine has now been discarded because of adverse effect of diabetes mellitus. Amphotericin-B is an effective drug but can cause nephrotoxicity. Miltefosine is a new oral effective drug which has recently been introduced in the kala-azar elimination program in the Indian subcontinent. Paromomycin is an injectable aminoglycoside which is quite cheap but can cause ototoxicity and nephrotoxicity. Sitamaquine, an oral antimalarial drug is still in phase-II trial stage. Combination Therapy is been tried with good results. Single dose Ambisome (liposomal Amphotericin-B) though costly is a very good alternative.